MEDICARE: TUONG THIEN NGUYEN PHARM D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	050011	NY

General Provider Information

NPI Number	:	1881788560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUONG THIEN NGUYEN PHARM D.

Provider Business Mailing Address
First Line	:	75-62 113TH ST #2C
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375
Country	:	US
Telephone Number	:	718-544-5767
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	11375
Country	:	US
Telephone Number	:	212-685-0500
Fax Number	:	212-532-6596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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